Menopause – where to turn for help

The menopause is something all women face at some point in their lives. Some pass through the transition relatively painlessly. For others it can be a traumatic time, both physically and emotionally. So just what can a woman expect and where can she turn for help?

The menopause is something all women face at some point in their lives. Some pass through the transition relatively painlessly. For others it can be a traumatic time, both physically and emotionally. So, just what can a woman expect and where can she turn for help?

What is the menopause?

The term menopause is often used to refer to the stage when a woman's reproductive cycle is coming to an end.

Women are born with a set number of eggs in their ovaries, and when egg numbers and quality start to decline a woman enters the peri-menopause stage.

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When the ovaries stop releasing eggs altogether, levels of the hormones oestrogen and progesterone go into sharp decline. These low hormone levels eventually cause a woman's periods to stop.

The average age for the menopause in the UK is 52. But it can be much earlier or later, typically ranging between 45 and 55.

What are the symptoms?

Often one of the first symptoms a woman notices is a change in her period pattern – with irregular periods or periods that are not as heavy as previously.

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Alternatively, periods may become heavier, with a shorter time span elapsing between periods. These changes can begin a few years before the last period.

As oestrogen also begins to decline, there may be other symptoms – such as hot flushes, night sweats, mood changes, joint aches, poor sleeping patterns and difficulty with concentration.

But not all women will experience all of these symptoms, and the severity can vary greatly.

'Each experience is unique, and that's why any treatment has to be individualised,' she says.

Intermediate symptoms

Two potential symptoms that are under reported are the effect on the vagina and bladder, says Dr Heather Currie.

With the drop in oestrogen the vaginal walls can become thin, making them dry and fragile. This can cause discomfort and pain during sex, which in turn can affect relationships.

The bladder can also be affected, with a frequent need for the toilet and pain when passing urine.

These affects are not always recognised as being associated with the menopause, but they can be easily treated.

Long-term health issues

Oestrogen helps keep bones strong, and so the drop in hormone levels that happens during this time can lead to the thinning of bones and even osteoporosis.

In order to keep your bones strong and healthy, you should make sure you are receiving plenty of vitamin D and calcium.

The other potential health concern is with your heart. Oestrogen is thought to have a good effect on the circulation and reduce plaque formation in the heart's arteries, and so a reduction in oestrogen levels is a potential cause of heart disease.

What you can do

Diet: if you're overweight, losing weight will help with menopausal symptoms. A healthy diet also protects against heart disease, diabetes and breast cancer.

Alcohol: too much alcohol can affect your bones, so try to cut down on your alcohol consumption.

Smoking: any kind of smoking is a risk to your bones and heart. Quitting will also help reduce the symptoms of menopause.

Caffeine: drinking coffee or any other caffeinated drink can reduce bone density and can worsen menopausal symptoms.

Exercise: regular physical exercise is good for your heart and will help to reduce your blood pressure.

Is hormone replacement therapy (HRT) safe?

But recent studies have found that if HRT is used by younger women – in their 50s as opposed to many of the much older women who had already gone through the menopause in the study – in the early stages of the menopause these risks are reduced.

'HRT has had bad publicity and now many doctors don't prescribe it, and many women won't take it,' says Dr David Sturdee, President of the International Menopause Society.

'Actually within the 50 to 59 age range there's no increased risk of heart disease, and for women who have been taking it for more than five years there's an extra eight cases per 10,000 women per year of breast cancer.

'HRT is not a panacea – and it's not suitable for everyone – but for women whose quality of life is severely affected, they should be allowed to decide for themselves and not be put off.'

What are the alternatives?

Black Cohosh and Red Clover are two herbal remedies often claimed to alleviate menopausal symptoms.

Another recent therapy, often called the natural alternative to HRT, is Bio-identical hormone replacement therapy. This uses hormones that are similar to drugs.

'Black Cohosh and Red Clover have been shown to have some benefits, but there hasn't been enough scientific placebo controlled trials to establish this,' says Dr Heather Currie.

'I also wouldn't recommend taking Bio-identical hormone replacement therapy because it's not as controlled as HRT, which is better to use and has been tested more.'

The emotional impact

Women who haven't had children, or want more, may have to come to terms with a broader emotional impact of the menopause – and it can also affect the way women think and feel about themselves.

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